医疗机构药品不良反应监测管理培训的效果分析

Effectiveness Analysis of Training on Adverse Drug Reaction Monitoring Management in Medical Institutions

关键词:  培训  药品不良反应  监测  效果

Key words:  training  adverse drug reaction  monitoring  effect

摘要:

目的 通过分析宁波市第一医院药品不良反应(ADR)监测工作的实际情况，找出医务人员在ADR监测工作中的不足与困难，探索建立有效的医疗机构ADR监测培训模式。方法 回顾性分析笔者所在医院2009—2013年ADR监测上报数据以及对全院医务人员开展ADR认知度调查，以了解医务人员获得ADR信息途径与培训现状，从而找出影响医务人员ADR报告积极性的主客观因素。结果 在实施一系列针对性改善措施后，2013年度ADR报告与2009—2012年平均值相比，数量明显增加(472例→644例，增幅达36.4%)；报告的质量也有了显著提高，2013年新的且严重的ADR报告例数增幅达681.8%；ADR报告主体由药学人员转变为临床医护人员，使得ADR报告时效性增强；重点监测药物别嘌呤醇片的严重ADR监测质量也显著增加(1.5例→7例)。结论 现阶段笔者所在医院建立的ADR监测培训新模式是行之有效的，值得推广。ADR监测工作是一项需要长期持续改善的系统工程，必须持之以恒和强化培训。

Abstract:

OBJECTIVE To find the problems and insufficiencies in Adverse Drug Reaction(ADR) monitoring work by analysis of the current situation of ADR monitoring in our hospital and to explore the effective training mode of ADR monitoring in medical institutions. METHODS ADR reports from 2009 to 2013 of our hospital were analyzed retrospectively and the investigation of ADR cognition for the medical staffs was carried out in order to learn about ways to obtain ADR information by the medical staffs and their training status. Moreover, the subjective and objective factors about spontaneously ADR reporting were found out. RESULTS The number of average annual ADR reports increased significantly in our hospital from 472 cases of 2009-2012 to 644 cases of 2013 after a series of targeted measures had been taken , the increase rate was 36.4%.Quality of the reports had also been greatly improved. New and serious ADR reports of 2013 increased by 681.8%. Meanwhile, the proportion of ADR reporting subject changed from pharmacists to doctors or nurses in order to enhance the ADR reports timeliness. As a key monitoring drug , the serious ADR caused by Allopurinol had also been greatly improved with average annual ADR reports increasing from 1.5 cases to 7 cases. CONCLUSION In our hospital the new mode of training on ADR monitoring established at present stage in our hospital is feasible and worth being adopted by other hospitals. But we must realize that ADR monitoring is a systematic project which needs long-term perseverance and intensive training.